Client Intake Form Template for Intermittent Fasting & Fitness

Use in FirstRep form

Personal Information

Gathering personal details helps tailor your intermittent fasting and fitness plan.

Aa Full Name *

Enter your full name

# Age *

Enter your age

Aa Email Address *

Enter your email address

Fasting Details

Understanding your current fasting routine will help personalize your program.

v Current Fasting Schedule *

# Duration of Fasting Practice (months) *

Enter duration in months

vv Fasting Goals *

Fitness Background

Your fitness history and preferences are key to creating an effective plan.

v Current Fitness Level *

vv Types of Workouts You Enjoy *

# Workout Frequency (days/week) *

Enter number of days

Nutrition Habits

Understanding your nutrition habits will aid in meal planning around your fasting schedule.

... Typical Meal Timing *

Describe your usual meal timing and choices

vv Food Preferences

# Hydration Level (L/day) *

Enter your average water intake

Challenges and Concerns

Identifying your challenges will help in developing strategies for success.

... Main Challenges with Fasting *

Describe your challenges, e.g., energy dips, social eating

Y/N Concerns about Muscle Preservation *

... Previous Injuries or Health Issues

List any relevant health concerns

Goals and Expectations

Defining clear goals will guide your intermittent fasting and fitness journey.

... Short-term Goals *

List your short-term fitness and fasting goals

... Long-term Goals *

Describe your long-term health and fitness vision

... Expectations from Coaching *

What do you expect from this coaching process?

Why Use This Template

Tailored Coaching

Personalized insights into your fasting and fitness habits will enhance your training.

Identify Challenges

Recognizing your pain points can lead to effective strategies that fit your lifestyle.

How to Use

Complete all sections to provide a comprehensive view of your fasting and fitness journey.

Submit the form to receive a tailored plan addressing your unique needs.

Customization Tips

Add personalized questions based on your coaching style.
Include a section for clients to outline specific dietary restrictions.
Allow clients to upload a photo for visual motivation.

Build and send intermittent fasting & fitness templates digitally with FirstRep. Free for up to 3 clients.

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Frequently Asked Questions

What is intermittent fasting?

Intermittent fasting is an eating pattern that cycles between periods of fasting and eating, aimed at weight management and health benefits.

Can I work out while fasting?

Yes, many people exercise during fasting periods. It's important to listen to your body and adjust intensity as needed.